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Kidney Week

Abstract: FR-PO221

Assessing the Impact of Hyperkalemia on Patient-Reported Quality of Life: A Global Analysis of the KDQOL-36 in a Real-World CKD Patient Population

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • Grandy, Susan, Astrazeneca, Gaithersburg, Maryland, United States
  • Jackson, James, Adelphi Real World, Macclesfield, United Kingdom
  • Qin, Lei, Astrazeneca, Gaithersburg, Maryland, United States
  • Moon, Rebecca, Adelphi Real World, Macclesfield, United Kingdom
  • Scott, Megan, Adelphi Real World, Macclesfield, United Kingdom
  • Palaka, Eirini, AstraZeneca, Cambridge, United Kingdom

Hyperkalemia (HK), defined as abnormally high serum potassium (K+>5mmol/L), is common in patients with chronic kidney disease (CKD) because of the effects of kidney disease on K+ homeostasis. Management of HK includes strict adherence to a low K+ diet which can be unhealthy and an added burden to patients. Evidence describing the impact of HK on patient reported outcomes is limited. The objective of this analysis was to assess the impact of HK on the Quality of Life (QoL) of non-dialysis (ND) CKD patients using the Kidney Disease Quality of Life Instrument (KDQOL), a validated CKD-specific questionnaire.


Data from the 2015 and 2018 Adelphi CKD Disease Specific Programmes were pooled to create a cross-sectional dataset of unique patients, including global data from physicians and their ND CKD patients across EU-5, China and USA. Patients completed the KDQOL, a disease specific self-report measure targeted at the particular concerns of individuals with kidney disease. CKD ND patients with HK (K+ >5.0 mmol/L) and without HK (i.e. those with normal K+ levels 3.5-5.0 mmol/L) were stratified to study the association between HK and QoL. Multivariate analysis was used to identify the association between HK and QoL, adjusting for age, sex, eGFR levels, and presence of heart failure and diabetes.


Results of the KDQOL analysis showed that ND patients with HK (n=216) had significantly lower mean QoL scores compared to those without HK (n=933) for 3 of the 5 KDQOL domains: burden of kidney disease (54.9 vs. 60.8; p=0.011), effects of kidney disease (69.6 vs. 76.1; p=<0.001) and physical health (39.1 vs. 41.6; p=0.001). Additionally, patients with HK had numerically lower scores for the remaining 2 KDQOL domains compared to patients without HK, namely symptoms/problems (80.1 vs. 82.1; p=0.134) and mental health (45.3 vs. 46.8; p=0.073).


This study highlights the negative impact of HK on the quality of life of CKD ND patients globally. HK contributes to the overall CKD disease burden, leading to further decrements in quality of life compared to patients without HK. Effective management of hyperkalemia may improve quality of life in this patient population.


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